Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: systematic review and network meta-analysis
| Autor: | Thaworn Sisayanarane, Alisara Arirachakaran, Wichan Kanchanatawan, Sorawut Laoratanavoraphong, Amnat Sukthuayat, Jatupon Kongtharvonskul |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Steroid injection
medicine.medical_specialty PRP medicine.drug_class Autologous blood Urology Review Article Injections 03 medical and health sciences Disability Evaluation 0302 clinical medicine Adrenal Cortex Hormones Internal medicine Tennis elbow Medicine Corticosteroid Humans Pain Management Orthopedics and Sports Medicine Lateral epicondylitis Network meta-analysis Pain Measurement Randomized Controlled Trials as Topic 030222 orthopedics business.industry Platelet-Rich Plasma Epicondylitis Tennis Elbow 030229 sport sciences medicine.disease Rheumatology Surgery Meta-analysis Platelet-rich plasma Systematic review business |
| Zdroj: | Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology |
| ISSN: | 1590-9999 1590-9921 |
| Popis: | Background Clinical outcomes between the use of platelet-rich plasma (PRP), autologous blood (AB) and corticosteroid (CS) injection in lateral epicondylitis are still controversial. Materials and methods A systematic review and network meta-analysis of randomized controlled trials was conducted with the aim of comparing relevant clinical outcomes between the use of PRP, AB and CS injection. Medline and Scopus databases were searched from inception to January 2015. A network meta-analysis was performed by applying weight regression for continuous outcomes and a mixed-effect Poisson regression for dichotomous outcomes. Results Ten of 374 identified studies were eligible. When compared to CS, AB injection showed significantly improved effects with unstandardized mean differences (UMD) in pain visual analog scale (VAS), Disabilities of Arm Shoulder and Hand (DASH), Patient-Related Tennis Elbow Evaluation (PRTEE) score and pressure pain threshold (PPT) of −2.5 (95 % confidence interval, −3.5, −1.5), −25.5 (−33.8, −17.2), −5.3 (−9.1, −1.6) and 9.9 (5.6, 14.2), respectively. PRP injections also showed significantly improved VAS and DASH scores when compared with CS. PRP showed significantly better VAS with UMD when compared to AB injection. AB injection has a higher risk of adverse effects, with a relative risk of 1.78 (1.00, 3.17), when compared to CS. The network meta-analysis suggested no statistically significant difference in multiple active treatment comparisons of VAS, DASH and PRTEE when comparing PRP and AB injections. However, AB injection had improved DASH score and PPT when compared with PRP injection. In terms of adverse effects, AB injection had a higher risk than PRP injection. Conclusions This network meta-analysis provided additional information that PRP injection can improve pain and lower the risk of complications, whereas AB injection can improve pain, disabilities scores and pressure pain threshold but has a higher risk of complications. Level of evidence Level I evidence |
| Databáze: | OpenAIRE |
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